Bone band and process of applying the same



Nov. 26, 1963 c. R. VON SOLBRIG BONE BAND AND PROCESS OF APPLYING THESAME INVENTOR. wesfiaon ,abr

Filed Jan. 5, 1961 United States Patent 3,111,945 BONE BAND AND PROCESSOF APPLYING THE SAME Charles R. von Solhrig, 64th) S. Keeler, @hicago29, Ill. Filed Jan. 5, 1961, Ser. No. 80,827 7 Claims. (Cl. 128-92) Thisinvention relates generally to the reduction and fixation of fracturedbones, and more particularly to the combination of a flexible band forwrapping around a fractured bone and fastening means for positivelysecuring the band to the bone. The invention also relates to the processof applying the aforementioned combination to a fractured bone.

To effect proper healing of fractured bones of human beings and otheranimals, it is necessary to restore the bone segments to their normalpositionthat is to say, to reduce the misplaced bone partsand to providesome means to retain the segments in such a position until they have hadan opportunity to knit. The retaining means will generally remain in thebody throughout the process of healing and will not be removed oncehealing is completed. Such means are usually only removed in the eventthere is irritation or infection resulting from their presence in thebody. Consequently, such retaining devices should be constructed only aslarge as necessary, should be easy to apply, and should not be composedof materials that may induce infection or cause other harm to the body.

Various means have been used heretofore to retain reduced parts offractured bones in their proper position. One such means is theintramedullary pin, an elongate, round or diamond-shaped, stainlesssteel pin of varying lengths, which is applied longitudinally with thebone and is invariably introduced into the highly vascular, soft tissue(marrow or medulla) filling the cavities of most bones. This invasion ofthe bone marrow cavity causes the circulation of blood therein to beimpeded and results in at least partial destruction of tissue. Reducedfractured bones are also retained in place by the Parham Band, a thin,flat elongate flexible element, which is wrapped around the fracturedbone segments and tensioned thereto by means of a clamp or similartightening instrument. This band tends to slip and frequently fails toprevent the bone parts from migrating after reduction.

Moreover, because the band is quite narrow, several are often requiredin a particular application, multiplying the chances that they will slipand complicating and lengthening the surgery. Suture wire representsstill another device .for retaining in place reduced fractured bones,but this wire is only used Where Parham Bands or the like cannot beused. The wire is more difficult to apply than the aforementioned b andand, to even a greater extent than the latter, tends to slip from thebone.

Accordingly, it is one important object of this invention to provide adevice for use in the reduction and fixation of fractured bones which,after it has been applied to the bone, will not slip and will hold thebone segments in place.

It is another object of this invention to provide a device for use inthe reduction and fixation of fractured bones which will not impedeblood circulation in the marrow cavity and will not destroy bone marrow.

Another object is to provide a device which may be used to retain intheir reduced position the small bone fragments resulting fromcomminuted fractures-that is, fractures in which the bone is shatteredinto several pieces.

It is a further object of this invention to provide for use in thereduction and fixation of fractured bones a device which may be simplyand economically constructed.

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It is a still further object of this invention to provide a process forretaining fractured bones in their reduced condition, which will notresult in the destruction of bone marrow and can be carried out in aquick, efficient and safe fashion.

Further and additional objects will be apparent from the drawings,description and claims.

In one form of this invention a band is provided which comprises aflexible member having a slender tip adjacent one end thereof and a slotadjacent the other end thereof for receiving the tip when the band isformed into a looped position. The band is perforated with a pluralityof apertures; and, when the band is wrapped about a bone, fasteningmeans are inserted into the bone through at least one such aperture. Inthis way the band is securely fastened to the bone and will not sliptherefrom, and the bone parts are prevented from shifting.

This invention may be applied to a reduced fractured bone by looping theband around the bone, interconnecting the opposed ends of the band byinserting the slender tip of the band into the slot therein, tensioningthe band with a tightening instrument or any other suitable means,securing the opposed ends together, and applying fastening means, suchas a screw or a nail, through at least one of the apertures of the b andand into the bone. Preferably, the fastening means should penetrate onlythe outer portion or cortex of the bone; it should not enter the marrow.

The product of this invention is especially useful in comrninuted,transverse, and oblique fractures. It may be used alone in mostapplications, but may be used in conjuncture with other devices wheredesirable. For example, in certain types of severe comminu-ted fracturesthe present invention may be used with intramedullary pins to retain thebone fragments in place.

To further illustrate this invention, drawings have been provided asfollows:

FIGURE 1 is a perspective view showing the band of the present inventionas applied to the bone with a clamp and with a fastening means insertedinto the bone through one aperture of the band.

FIG. 2 is a plan view of one embodiment of the band 8f the presentinvention before it has been applied to a one.

FIG. 3 is a cross section taken along line 33 of FIG. 2.

FIG. 4 is a perspective view showing the embodiment of FIG. 2 with itsopposed ends interconnected.

FIG. 5 illustrates a cross section of a bone with the band shown in FIG.2 applied thereto and with a thread ed member inserted into the bonethrough one of the apertures of the band.

FIG. 6 is a plan view of a modification of the embodiment of FIG. 2.

Referring now to the drawings, and particularly to FIGS. 2 and 3, athin, flexible, substantially non-elastic band 10 is provided, "which isgenerally constructed of high-quality stainless steel. The band It) hasa slender tip 12 and a slot 14 at the opposite end. The slot 14 must beconstructed sufficiently long and wide to receive the tip 12, which isinserted through the slot 14 when the band is looped about a bone (see,for example, FIG. 4). Thus, the portion of the band containing the slot14 must be wider than the slender tip 12. One particular form of band 10has an overall length of approximately seven inches, of which about 4%inches comprises the slender tip 12 and about 2% inches consists of asomewhat wider portion 22. The tip 12 is about 7 inch wide and the Widerportion 22 about /2 inch wide. The aforesaid form of band 10 is lessthan /32 of an inch thick.

The band 10 is perforated with a plurality of apertures 20 which arelocated on the wider portion 22 of the band. In FIG. 2 the band 10 isshown having four ap ertures, each of which may be approximately fi ofan inch in diameter, arranged along a straight line substantiallyparallel to and equidistant from the longitudinal edges of the band. Itwill be understood, however, that more or fewer apertures of varyingsizes may be used where desirable and, moreover, that the apertures neednot be positioned as shown in FIG. 2. For example, FIG. 6 illustrates amodification 28 of band 10, which contains a considerably wider portion28a than the corresponding portion 22 of band 10, the modified portionbeing about one inch in width. Located on portion 28a are twelveapertures 30 arranged in three rows, rather than four apertures arrangedin one row, as on band 10. The dotted lines on the band, shown in FIG.6, illustrate that the portion 28a of modification 28 may be shortenedand the number of apertures therein decreased. The same, of course, istrue of the corresponding parts of the embodiment of this inventionillustrated in FIG. 2.

The band is applied by wrapping it around the bone and inserting theslender tip 12 into the slot 14, as shown, for example, in FIGS. 1 and5. FIG. 4 illustrates most clearly the manner in which the tip 12 isinserted into the slot 14. The band is then tightened to the desiredtension by clamp means 16, shown in FIG. 1, which perates on a principlesimilar to that employed by a turnbuckle. Clamp means 16, comprises aframe 16a, which is provided with an aperture 16b in the upper portionthereof, and a threaded member 160 rotatably connected to the frame 16athrough a threaded aperture 16a, the threaded member having aprotuberance 16e on the upper end and a knob 16f on the lower end. Afterthe band 10 has been looped about the bone and the tip 12 has beeninserted through the slot 14, the clamp means 16 is connected to theband by inserting the tip 12 through the aperture 16b and securing thetip to the threaded member 160 by inserting protuberance 162 into theslit 18 provided in tip 12. As the knob 16 is turned, the threadedmember is actuated in either a downward or upward direction and the band.10 is thereby tightened or loosened. Tightening to the bone is effectedby actuating the threaded member with the slender tip 12 attachedthereto downward until the upper portion of clamp means 16 abuts theband 10 and then continuing the downward movement of the threaded memberuntil the desired degree of tension is attained. Once the band has beenproperly tightened, the tip 12 is twisted or secured in some other wayto prevent it from slipping back through slot 14, the clamp means 16 isremoved, and the surplus band, if any, is severed by suitable cuttingmeans.

After the band is looped about the bone and tightened thereo, a screw24, nail, or other fastening means, generally constructed of highquality stainless steel, is applied transversely to the bone through oneof the apertures 20, as illustrated in FIGS. 1 and 5. More than onefastening means may be used where necessary. By using fastening means,such as screw 24, the band is thus prevented from slipping off the bonesegments and the bone portions are prevented from shifting from theirreduced positions, two problems quite prevalent when the prior artdevices are employed.

FIG. shows the band of the present invention after it has been appliedto a bone 26. As can be seen from this drawing, the screw 24 penetratesthe cortex 26a of the bone, but is not long enough to enter the marrow26b. For most applications the fastening means will be only a fractionof an inch in length. Its head should have a maximum diameter greaterthan the minimum diameter of the aperture through which the fasteningmeans is to be inserted, so as to prevent the band from slipping overthe head of the screw; and the head may have any suitable shape and maybe any suitable type. The head 24a of the screw 24 is a round,Phillips-type head.

Broadly, the process of this invention comprises looping a band aboutthe reduced bone segments and applying a fastening means into the bonethrough the band to positively secure the band to the bone. Morespecifically, the process of this invention may comprise, for example,looping the band 10 about a fractured bone after the segments thereofhave been restored to their proper position, interconnecting the opposedends of the band 10 as shown in FIG. 4, tensioning the band on the boneas illustrated in FIG. 1, twisting or otherwise securing the free end 12of the band to prevent such free end 12 from slipping back through slot14 and loosening the band, severing the excess portion of the free end12, and applying suitable fastening means, such as the screw 24 shown inFIGS. 1 and 5, into the bone through one of the apertures 20 in the band10.

Although specific embodiments of this invention are described above,certain modifications may be made within the bounds of this invention.For example, the dimensions of the band are not limited to thosespecifically shown, but may be varied as required by the particularapplication; and, if desired, more or fewer apertures may be provided inthe band than are shown in the embodiments set forth herein. Also, theapertures need not be arranged as in disclosed embodiments, but may bedistributed in any pattern according to the needs of the user. Althougha specific screw is set forth in illustration of a fastening means,where proper and desirable, other types of screws, nails or the like maybe used in lieu thereof. Finally, it should be noted that any suitablematerial other than stainless steel may be utilized to construct boththe band and the fastening means.

While particular embodiments of this invention are shown above, it willbe understood, of course, that the invention is not limited thereto,since many modifications may be made, and it is contemplated, therefore,by the appended claims, to cover any such modifications as fall withinthe true spirit and scope of this invention.

I claim:

1. An article for retaining reduced fractured bone in place, whicharticle is generally inert with respect to the body fluids, comprisingflat flexible means adapted to surround said bone in a single loop undertension, and fastening means adapted to be inserted into the bonethrough said flexible means, said flexible means having apertures forreceiving said fastening means and having at least one other aperture.

2. An article for retaining reduced fracture bone in place, whicharticle is generally inert with respect to the body fluids, comprisingflat flexible means adapted to surround said bone in a single loop undertension, said flexible means having a plurality of apertures therein,and fastening means adapted to be inserted into the bone through one ofsaid apertures.

3. An article for retaining reduced fractured bone in place, whicharticle is generally inert with respect to the body fluids, comprisingflat flexible means adapted to surround said bone in a single loop undertension, said flexible means having a plurality of apertures therein,and fastening means adapted to be inserted into the bone through one ofsaid apertures, said fastening means being so constructed that it isprevented from entering the bone marrow.

4. An article for retaining a reduced fractured bone in place comprisinga flat flexible band having a plurality of apertures therein and havingits free ends interconnected to form a closed single loop under tensionabout the bone, and fastening means adapted to be inserted into the bonethrough one of said apertures to positively secure said band to thebone, said fastening means being so constructed that it is preventedfrom entering the bone marrow.

5. An article for retaining a reduced fractured bone in place comprisinga flat flexible band having its free ends interconnected to form aclosed single loop under tension about the bone, and having a pluralityof apertures; and threaded means adapted to be inserted into the bonethrough one of said apertures, said threaded means having thereon a headwhich has a maximum diameter greater than the minimum diameter of saidaperture, and being so constructed that it is prevented from enteringthe bone marrow.

6. An article for retaining a reduced fractured hone in place Withoutinvading the bone marrow comprising a flat flexible band having means atthe free ends thereof for securing said ends together to form a closedsingle loop under tension on said bone, said band also having aplurality of apertures therein; and a threaded means adapted to beinserted into the bone through one of said apertures, said threadedmeans having a head thereon which has a maximum diameter greater thanthe minimum diameter of said aperture and said threaded means also beingso constructed that it is prevented from entering the bone marrow.

7. An article for retaining reduced fractured hone in place Withoutinvading the bone marrow comprising a flexible band adapted to be loopedabout the bone under tension, said band having a slender tip adjacentone end thereof and a slot adjacent the other end thereof for ReferencesCited in the file of this patent UNITED STATES PATENTS 1,105,105 ShermanJuly 28, 1914 1,346,940 Collins July 20, 1920 FOREIGN PATENTS 600,103Great Britain Mar. 31, 1948 OTHER REFERENCES Bickharns OperativeSurgery, copyright 1924 (only Figs. 1406 and 1407 and page 367 reliedupon). (Copy in Division 55.)

Murray-Baurngartner Surgical Inst. Co. Catalog, Dec. 26, 1934 (onlyFigs. 1607-1608 and page 90 relied upon). (Cop-y in Division 55.)

1. AN ARTICLE FOR RETAINING REDUCED FRACTURED BONE IN PLACE, WHICHARTICLE IS GENERALLY INERT WITH RESPECT TO THE BODY FLUIDS, COMPRISINGFLAT FLEXIBLE MEANS ADAPTED TO SURROUND SAID BONE IN A SINGLE LOOP UNDERTENSION, AND FASTENING MEANS ADAPTED TO BE INSERTED INTO THE BONETHROUGH SAID FLEXIBLE MEANS, SAID FLEXIBLE MEANS HAVING APERTURES FORRECEIVING SAID FASTENING MEANS AND HAVING AT LEAST ONE OTHER APERTURE.